| NPI | 1275591802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE ANN HALE Director Of Accounting 310-301-5311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0000X Family Medicine Adolescent Medicine |
| 207QA0505X Family Medicine Adult Medicine | |
| 207QG0300X Family Medicine Geriatric Medicine | |
| 207QS0010X Family Medicine Sports Medicine | |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2024-03-26 |